Pharmacology reference by Michael L. Iczkovitz, D. D. S



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Antacid

Dihydroxyaluminum Sodium Carbonate (Rolaids)

Action: Neutralizes stomach acid.

Use: Relief of upset stomach due to hyperacidity.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: Decreases absorption of ketoconazole and itraconazole.




Antacid +

Action: Neutralizes gastric acidity, supplies calcium which is needed for muscle contraction, bone formation and combines with dietary phosphate to form insoluble calcium phosphate which is excreted in feces.

Use: Treatment and prevention of calcium depletion (osteoporosis, osteomalacia), control of hyperphosphatemia in end stage renal disease and as antacid.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Myalgia.

Antacid +

  • Calcium Product (continued)

Dental Drug Interactions: Decreases tetracycline, anticholinergic, ketoconazole and sodium fluoride absorption.

Calcium Carbonate (Tums)




Antacid +

  • Magnesium Salt

Action: Reacts with hydrochloric acid in stomach to form magnesium chloride. Promotes bowel evacuation by causing osmotic retention of fluid, which distends the colon and results in increased peristaltic activity.

Use: Short term treatment of constipation and symptoms of hyperacidity. Magnesium replacement therapy.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: Decrease absorption of tetracyclines and indomethacin.

Magnesium Hydroxide (Milk of Magnesia)




Laxative

Action: Bulk producer, stool softener, works by absorbing water into intestine, which promotes peristalsis.

Use: Treat constipation

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: None

Docusate (Colace) Leaves bitter taste causes sore throat.

Psyllium (Metamucil) Decreases effect of coumadin, salicylates and tetracycline. Treat irritable bowel syndrome also.

Calcium Polycarbophil (FiberCon) Decreases effect of tetracycline. Can use to treat diarrhea or constipation.




Laxative

Action: Irritates smooth muscle of intestine stimulating peristalsis. Also promotes water and electrolyte secretion into the intestine.

Use: Treat constipation, colonic evacuation prior to surgery or examination.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: Decreases effect of oral anticoagulants.

Bisacodyl (Fleet, Dulcolax enemas)




Antidiarrheal

Diphenoxylate and Atropine (Lomotil)

Action: Inhibits gastric motility by acting on mucosal receptors responsible for peristalsis. Narcotic related to meperidine. Atropine in to discourage abuse.

Use: Simple diarrhea.

Antidiarrheal (continued)

Diphenoxylate and Atropine (Lomotil)

Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth and headache.

Dental Drug Interactions: Increased effects of alcohol, CNS depressants, opiod analgesics and anticholinergics.

Antidiarrheal

Loperamide (Imodium)

Action: Slows intestinal motility and effects water and electrolyte movement through the bowel.

Use: Control and symptomatic relief of acute nonspecific diarrhea, including traveler’s diarrhea.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: None




Colon Acidifier

Action: Bacteria degradation of lactulose in the colon acidifies colonic contents. This results in ammonium ion retention in the colon and its excretion with a net decrease in blood ammonium concentration.

Use: Prevention and treatment of portal-systemic encephalopathy, including the stages of hepatic pre-coma and coma.

Dental Considerations: Local anesthetic with vasoconstrictor ok.

Dental Drug Interactions: None.

Lactulose (Cephulac, Duphalac)




Pancreatic Enzymes

Lipase, Amylase and Protease (Creon 10)

Action: Lipase breaks downs fat, amylase breaks down starch and protease breaks down protein for digestive purposes.

Use: Treat pancreatic exocrine insufficiency.

Dental Considerations: Local anesthesia with vasoconstrictor ok.

Dental Drug Interactions: None




Estrogen

Action: Hormone required for the development, maintenance and adequate function of the female reproductive system. Does this by increasing synthesis of DNA, RNA and selective proteins.

Estrogen (continued)

Also decreases the release of gonadotropin-releasing hormone, inhibits ovulation and helps maintain bone structure.

Use: Treat menopause, breast cancer, prostatic cancer, abnormal uterine bleeding, hypogonadism, ovariectomy, primary ovarian failure, prophylactic for osteoporosis.

Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, exacerbates gingivitis and gingival bleeding. Increases alveolitis after tooth extraction.

Dental Drug Interactions: Increases action of corticosteroids. Increases potential for thromboembolic events with anticoagulants by decreasing anticoagulant effect. Oral antibiotic may decrease estrogen effect.

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